Sunshine List for Physicians

November 6, 2015

Dr. Carl W. Nohr, AMA President

Dear Member:

I had intended my next President’s Letter to be a follow-up on the fee review work being done by the Physician Compensation Committee. However, the government tabled a bill (yesterday) known as Bill 5: The Public Sector Compensation Transparency Act commonly referred to as sunshine legislation.

Here is a link to the announcement:
http://alberta.ca/release.cfm?xID=388018027C935-C84A-E652-443FB53A3AA53C51.

Here is a link to the department of justice description of Bill 5: https://www.justice.alberta.ca/programs_services/law/Publications_Library_Law/PublicSectorCompTransAct.aspx.

Here is what we know:

Bill 5 was introduced by the Government of Alberta to increase transparency by addressing the disclosure of compensation paid to a wide variety of public sector employees, appointees, physicians and other health practitioners.

This proposed legislation would require compensation disclosure for certain employees who work for health service agencies. The threshold for disclosure is proposed to be $125,000.

The Honorable Kathleen Ganley, Minister of Justice and Solicitor General, has indicated that parties impacted by this legislation will be consulted to help determine how to implement the act as the regulations are drafted. The Alberta Medical Association (AMA) has been specifically referenced as a body to be consulted.

For physicians, the disclosure will include fee-for-service payments and other types of payments made by the Government of Alberta, Alberta Health Services, the Alberta Medical Association and other health care entities such as Covenant Health. There will likely be direct implications for the AMA. Some government payments are made through our organization and there may be additional reporting requirements.

The first disclosure under the act will be June 30, 2016, but this timeline may or may not be implemented for physicians.

Here is what we will do:

I have already given several press interviews, emphasizing the principal issues of privacy and the risk attached to misunderstanding the figures, and that we will be consulting the membership about these and other concerns.

The desire for transparency needs to be balanced with the privacy rights of individuals. This will be a priority for the AMA.

There is also a major concern with the risk of misunderstanding what the numbers mean. Many physicians work very long hours to meet the need for medical services for Albertans and these hours are reflected in payments. Also, most Alberta doctors are small business operators, and contribute a significant portion of the fees they receive to the communities they work in, in terms of staff salaries, leases, and equipment and supply costs. Although associated with a particular doctor’s name, revenue is to the practice and is not the doctor’s income.

We appreciate that the government is going to consult with the AMA and include us in the development of the regulations attached to the legislation, and we will be paying careful attention to this.

We’ll be listening to you as we gather your feedback and concerns with Bill 5 and we’ll be relaying those issues to government.

Please let me know what you think about Bill 5. Please email me at president@albertadoctors.org or leave a comment below.

Kind regards,
Carl W. Nohr, MDCM, PhD, FRCSC, FACS
President

5 comments

Commenting on this page is closed.

  • #1

    Sherif El Maadawy

    Physician

    7:28 PM on November 06, 2015

    I am a community pain physician.

    I have 4 full time employees, I pay 143,000 in rent for my clinic per year. I also pay EMR of 1000$ per month, 550$ for IT company to run the servers on site and off site, 200$ for liability insurance, 2000$ medical supplies and monthly lease for the medical equipment. 2000$ per month for the tenant improvement loan to work in a decent clinic.

    I work 70 hours on average per week.

    I also pay the highest tax bracket ever for my personal income. High corporate tax as well. I am so tired and stressed out. I am thinking to retire at age of 46 years old Or work in a different country and change all my family life. I take care of 2000 patients per year who suffer from chronic pain. I am not sure what I will do next year specially with the significant tax hike and the government harrasment to us.

    Can they also publish my cost to run my clinic?

    Thanks a lot to give me a chance to vent.

    Dr. Sherif El maadawy, MD FRCPC

  • #2

    John Hagens

    Physician

    9:51 PM on November 06, 2015

    Good Evening Dr. Nohr,

    I appreciate your concerted efforts as they are ongoing on behalf of our membership at this time. I am sure that this has created new and difficult pressures for you in your present position as our lead AMA representative.

    I am presently involved in roles of curriculum development and educational leadership within the University of Calgary's Department of Academic Family Medicine, in addition to active teaching roles. Prior to this, I was involved in active, full service rural medicine for fifteen years.

    I must note that I am very troubled with this legislation, as it does not serve to create nor improve transparency regarding our income. As you have mentioned, our earnings do not represent our actual income, and this would likely significantly mislead both our government representatives and the public in general if provided out of context.

    Second, physicians in Alberta are not of necessity AHS employees; nor are we independent contractors. We are dependant upon the government funding as provided, to the best of our ability to advocate for ourselves via the AMA.

    Further rural physicians in particular will be subject to potentially pejorative views from members of their community with published income data, leading to additional stresses endemic to living and conducting business both professionally and personally within relatively isolated communities.

    Finally, I feel that as physicians we are seemingly unfairly targeted on many fronts, adding to the stresses in general relating to medical practice in Alberta. I view the legislation proposed in Bill 5 to appear as another affront to our autonomy and professionalism as physicians. If the government wishes to make us public employees, with full benefits as afforded to its other employees, then let's negotiate this and publish our standardized income. Until such time, it is my secure belief that we need to stand united against this unnecessary, injurious, and personally disadvantageous legislation without concession.

    Dr. John Hagens

  • #3

    Salim Hamid

    Physician

    11:14 PM on November 06, 2015

    I am a psychiatrist in private solo practice , I would like government know that I employ 4 part time staff.My rent is $6600 dollars a month and other overhead expenses should also be made public with my billings to AH and wellness
    I worked in excess of 60 hours a week

  • #4

    Adeboye Efunnuga

    Physician

    2:33 AM on November 07, 2015

    I have taken time to go through the request and it makes no sense to me, to best of my knowledge and as it affects fee for service, the payment is not to me but an incorporated company, the fee paid through this incorporated company does not go to one individual but several interested parties that includes the clinic the own the facilities i sue for my work, the RIC assistance that work with me, myself and other people that directly or indirectly get paid though the incorporated company for services rendered on monthly basis
    So far all this are captured in the information provided i have no problem with that but to equate fee paid to the company as being equal to fee paid directly to me amounts to misinformation

  • #5

    Les Eidus

    Physician

    10:13 AM on November 09, 2015

    This is deja vu. Anybody who has worked in Ontario as a salaried physician (e.g. Pathologists) has seen this. It started in the 1990’s, also at a time of a recession. We had our salaries published in the local newspapers. The government oozed accusatory undertones. It was the opening salvos of desperate attempts to restrain health care spending. This was followed by "rationalization". Together with federal government cutting billions out of health care, there ensued an exodus of physicians. By the time I got to Saudi Arabia, many of the staff and department heads were Canadian physicians. Canadian nurses, and allied health were also well represented in the Gulf States. I imagine that many more health professionals went to the USA. I had counted 40% physician turn over two years in one department.

    If the government is serious about implementing effective change, Bill 5 is not an auspicious start. Regards … Les Eidus

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